Derivation of a tuberculosis screening rule for sub-Saharan African prisons

Harris, Jennifer B.; Siyambango, M.; Levitan, Emily B.; Maggard, Katie R.; Hatwiinda, Sisa; Foster, E. Michael; Chamot, Eric; Kaunda, Kenneth D.; Chileshe, C.; Krüüner, Annika; Henostroza, German; Reid, Stewart E.

doi:10.5588/ijtld.13.0732

Cited by 18 publications

(24 citation statements)

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“…Measures of association between TB and HIV positivity were variable amongst those studies that reported it, with some finding no significant association [40,58,60,65,73,75] whilst others reported highly significant associations between the two infections, with relative risks of co-infection ranging from 2.0 to 10.75 [51,58]. …”

Section: Resultsmentioning

confidence: 99%

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Edge

King

Dolan

et al. 2016

Journal of the International AIDS Society

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IntroductionAlmost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the high prevalence of HIV-positive persons and TB-infected persons in prisons and the documented risk of TB in those infected with HIV, it is of interest to determine how co-infection varies amongst prison populations worldwide. For this reason we have undertaken a systematic review of studies of co-infected prisoners to determine the incidence and/or prevalence of HIV/TB co-infection in prisons, as well as outcomes in this group, measured as treatment success or death.MethodsA literature search was undertaken using the online databases PubMed, Embase, IBSS, Scopus, Web of Science, Global Health and CINAHL Plus. No restrictions were set on language or publication date for article retrieval, with articles included if indexed up to 18 October 2015. A total of 1975 non-duplicate papers were identified. For treatment and outcome data all eligible papers were appraised for inclusion; for incidence/prevalence estimates papers published prior to 2000 were excluded from full text review. After full text appraisal, 46 papers were selected for inclusion in the review, 41 for incidence/prevalence estimates and nine for outcomes data, with four papers providing evidence for both outcomes and prevalence/incidence.ResultsVery few studies estimated the incidence of TB in HIV positive prisoners, with most simply reporting prevalence of co-infection. Co-infection is rarely explicitly measured, with studies simply reporting HIV status in prisoners with TB, or a cross-sectional survey of TB prevalence amongst prisoners with HIV. Estimates of co-infection prevalence ranged from 2.4 to 73.1% and relative risks for one, given the other, ranged from 2.0 to 10.75, although some studies reported no significant association between HIV and TB. Few studies provided a comparison with the risk of co-infection in the general population.ConclusionsPrisoners infected with HIV are at high risk of developing TB. However, the magnitude of risk varies between different prisons and countries. There is little evidence on treatment outcomes in co-infected prisoners, and the existing evidence is conflicting in regards to HIV status influence on prisoner treatment outcomes.PROSPERO Number: CRD42016034068

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Section: Resultsmentioning

confidence: 99%

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Edge

King

Dolan

et al. 2016

Journal of the International AIDS Society

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“…To maximise efficiency and control costs, evidence-based screening tools are needed, 70 but few reports from sub-Saharan Africa have been published to guide how to screen detainees for tuberculosis. The sensitivity and specificity of symptom screening varies depending on the number of symptoms included.…”

Section: Tools Approaches and Structural Interventions To Preventiomentioning

confidence: 99%

“…The sensitivity and specificity of symptom screening varies depending on the number of symptoms included. 27,70 In Zambian detainees, low body-mass index and HIV infection had moderate sensitivity (60%) for tuberculosis. 70 Among South African detainees, the use of chest radiography in addition to symptoms improved screening sensitivity from 24–38% to 70–80%.…”

Section: Tools Approaches and Structural Interventions To Preventiomentioning

confidence: 99%

“…27,70 In Zambian detainees, low body-mass index and HIV infection had moderate sensitivity (60%) for tuberculosis. 70 Among South African detainees, the use of chest radiography in addition to symptoms improved screening sensitivity from 24–38% to 70–80%. 27 These results are in keeping with findings from other continents, 71,72 which suggests that use of chest radiography is beneficial among prison populations.…”

Section: Tools Approaches and Structural Interventions To Preventiomentioning

confidence: 99%

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HIV and tuberculosis in prisons in sub-Saharan Africa

et al. 2016

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Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2.3% to 34.9%, and of tuberculosis from 0.4 to 16.3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are required throughout sub-Saharan Africa to develop country-level policy guidance, build human-resource capacity, and strengthen prison health systems to ensure universal access to HIV and tuberculsosis prevention, treatment, and care of a standard that meets international goals and human rights obligations.

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“…A infecção pelo vírus HIV é um fator que aumenta a vulnerabilidade do acometimento por TB na população em geral. Em indivíduos privados de liberdade, esta infecção apareceu como um fator de risco ainda mais acentuado 16,20,28 . No indivíduo infectado pelo HIV e pelo M. tuberculosis ocorre a aceleração do declínio das funções imunológicas, devido aos patógenos potencializarem-se mutuamente.…”

Section: Discussionunclassified

Fatores predisponentes de tuberculose em indivíduos privados de liberdade: revisão integrativa

Silva

Temóteo

Véras

et al. 2019

ACS

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Introdução: O ambiente prisional proporciona predisposição de diversas doenças, como é o caso da tuberculose, cujo risco de adoecimento aumenta em 28 vezes no interior das prisões. Objetivo: Integrar os fatores causadores de tuberculose em indivíduos privados de liberdade, mencionados na literatura nacional e internacional. Materiais e Métodos: Trata-se de uma revisão integrativa realizada nas bases de dados LILACS, MEDLINE e PUBMED nos meses de abril a junho de 2017. Resultados: A amostra foi constituída por 12 estudos. Os resultados permitiram constatar que o uso de drogas ilícitas injetáveis, o tempo de encarceramento, o compartilhamento de cela com outros detentos e a coinfecção HIV/TB foram os principais fatores relacionados ao adoecimento por tuberculose na população penitenciária. Ademais, a tuberculose pulmonar foi o principal achado dentro do ambiente prisional, seguida pela infecção latente por tuberculose. Conclusão: O controle da tuberculose é uma necessidade urgente na sociedade. O desenvolvimento de programas de controle desta, bem como a instalação de serviços de saúde efetivos, que promovam um cuidado integral e a prevenção e promoção, assim como a reabilitação da saúde das pessoas privadas de liberdade constitui-se em uma necessidade imperiosa no contexto prisional.

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Derivation of a tuberculosis screening rule for sub-Saharan African prisons

Abstract: Low BMI and HIV infection were the most robust predictors of TB in our inmates; chest pain was additionally retained in one model. BMI and HIV should be further evaluated as the basis for TB screening rules for inmates, with modification as needed to improve the performance of the rules.

Cited by 18 publications

References 0 publications

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Prisoners co‐infected with tuberculosis and HIV: a systematic review

HIV and tuberculosis in prisons in sub-Saharan Africa

Fatores predisponentes de tuberculose em indivíduos privados de liberdade: revisão integrativa

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